Effects of Equine Assisted Activities on Autism Spectrum Disorder

Quality of life assessments were used in this study to determine the behavioral changes of children diagnosed with autism spectrum disorder (ASD) who participated in equine assisted activities. Behavioral changes of children with ASD participating in 9 weeks of equines assisted activities (EAA) (N = 10) were compared to behavioral changes of children who participated in a non-equine intervention (N = 8). Parents noted significant improvements in their child’s physical, emotional and social functioning following the first 6 weeks of EAA. The children participating in the non-equine program also demonstrated improvement in behavior, but to a lesser degree. The favorable outcome of this study lends support for continuation of programs utilizing EAA in the treatment of children with ASD.     

Bereavement: Course,Consequences, and Care

This paper discusses each of several potential consequences of bereavement. First, we describe ordinary grief, followed by a discussion of grief gone awry, or complicated grief (CG). Then, we cover other potential adverse outcomes of bereavement, each of which may contribute to, but are not identical with, CG: general medical comorbidity, mood disorders, post-traumatic stress disorder, anxiety, and substance use.     

Facial skin rejuvenation by combination treatment of IPL followed by continuous and fractional radiofrequency

Objective: The objective of this study was to evaluate the safety and efficacy of combination facial treatment by 3 technologies. Materials and methods: Eleven patients completed the clinical trial that consisted of alternate treatments of intense pulsed light (IPL) in 3 sessions and continuous + fractional bipolar radiofrequency (RF) in 3 alternating sessions, 3 weeks apart. Follow-up visits were made at 6 and 12 weeks following the last treatment. Lesions were evaluated by photographs taken at baseline and at follow-up time points according to predetermined scales. Results: Results showed statistically significant improvement in wrinkling (24% after 6 weeks and 33% after 12 weeks), pigmentation (38% after 6 weeks and 62% after 12 weeks), vascular lesions (29% after 6 weeks and 67% after 12 weeks), and laxity (37% after 6 weeks and 40% after 12 weeks). Conclusions: Combination facial treatment by IPL, and continuous and fractional RF is safe and enables the treatment of a variety of facial lesions, taking advantage of accessible applicators for different clinical indications on the same device. Thus, comprehensive facial skin rejuvenation has become feasible.     

Addressing career barriers for high risk adolescent girls: The PATHS curriculum intervention

The study evaluated a gender-specific comprehensive career development curriculum designed to target career barriers faced by high risk adolescent girls – those with disabilities and at risk for school failure. The goal of the curriculum was to promote social cognitive career and self determination outcomes associated with adaptive career development and adjustment. A pre-post control group design was used to evaluate the curriculum. Findings suggest that participation in the curriculum resulted in significant and large gains in autonomy and in disability and gender-related knowledge. Meaningful gains were noted in perceptions of social support and relevance of school. Participants in a high fidelity sample made significant and large gains in vocational skills self-efficacy and disability and gender-related knowledge. Meaningful improvements were noted in self-advocacy, autonomy, and vocational outcome expectations. The findings suggest that the curriculum can improve important indicators of positive career development and adjustment in high risk adolescent girls.     

The Right to Health,International Human Rights Legislation and Mental Health Policy and Care Practices for People with Psychiatric Disability

This article is based on research which examined the current and potential impact of the United Nations Convention on the Rights of Persons with Disabilities (CRPD) on Australian and South Australian legislation and policy. A particular focus was on the ‘right to health’ for people with a psychiatric disability. Ten interviews were conducted with professionals from law, psychiatry, government and service user advocacy, working at state, national (Australian) and international levels. It addresses three key themes: the rights of people with psychiatric and other disabilities; perceptions of the rollout of the United Nations Convention on the Rights of Persons with Disabilities (CRPD); and the impact on current policy and practice of the ‘right to health’.     

Returning to work with aphasia: A case study

Background: For some people with aphasia, returning to work will be their eventual goal. While there are reports in the literature of incidence of return to work, and general discussion of success, there are few documented in depth studies of what this might entail for the individual with aphasia.

Aims: This paper explores returning to work with aphasia, and examines the complex relationship between the person, the aphasia and the demands of employment.

Methods & Procedures: This is a detailed case report, describing and reflecting on the experiences of GD, who returned to work following his stroke and aphasia. Therapy focused specifically on work requirements is described and the factors affecting GD's return to work explored. An interview was used to elicit GD's reflections on his experiences.

Outcome & Results: GD's language skills improved over time and with therapy, and he developed several strategies that facilitated his communication. He was able to return to work (part-time) in a modified role and this was successful initially. After an extended period (～19 months) his employment was terminated and GD explored other options. He moved on to a volunteering and charity trustee role.

Conclusions: The success (or not) of returning to work with aphasia is multi-faceted and does not rest solely with the person with aphasia. The nature of the work may have a strong bearing on success, as will the ability and willingness of the employer to engage in the process. Partnership with the person and constant review of goals and management is of overwhelming importance. We need to consider what “success” may mean in this context and the need to consider therapeutic and rehabilitation needs over a longer time frame.     

Modified Response Elaboration Training: A systematic extension with replications

Background: Response Elaboration Training (RET; Kearns, 1985 Kearns, K. P. 1985. “Response elaboration training for patient initiated utterances”. In Clinical aphasiology, Edited by: Brookshire, R. H. 196–204. Minneapolis, MN: BRK.  [Google Scholar]) has been found to consistently result in increased production of content in discourse with persons with aphasia. Positive treatment effects have been reported for persons representing a variety of aphasia types and severities. RET was modified for application with persons with acquired apraxia of speech and aphasia and positive outcomes were also associated with the modified treatment (Wambaugh & Martinez, 2000 Wambaugh, J. L. and Martinez, A. L. 2000. Effects of rate and rhythm control treatment on consonant production accuracy in apraxia of speech. Aphasiology, 14: 851–871. [Taylor & Francis Online], [Web of Science ®] , [Google Scholar]). Although RET has received systematic study, its stimulus generalisation effects are not well understood.

Aims: This investigation was designed to measure the stimulus generalisation effects of modified RET (M-RET) in a variety of conditions as well as to further study the effects of M-RET applied to a personal recount condition.

Methods & Procedures: Multiple baseline designs (across behaviours and participants) were utilised to examine treatment effects. Treatment was applied sequentially to picture sets and a personal recount condition with six persons with chronic aphasia. Production of correct information units (CIUs) was measured in the following conditions: (1) discourse production in response to sets of trained and untrained pictures, (2) home conversations, and (3) production of discourse in structured tasks. Formal measures of functional communication were also completed prior to and following treatment.

Outcomes & Results: Increases in production of CIUs in response to pictures were observed for 11 of the 12 applications of M-RET to picture sets. Response generalisation to untrained picture sets was associated with M-RET applied to pictures sets; increases were slight and were greater for untrained sets that were probed more frequently. Maintenance of gains was generally strong for the participants with nonfluent aphasia, but was minimal for the participant with fluent aphasia. Gains were not evident for M-RET applied to personal recounts; only one participant evidenced changes possibly associated with treatment in the personal recount condition. Improvements in structured discourse samples and a functional communication measure were observed for the majority of the participants following treatment. Lack of compliance in completion of recordings of home conversations limited the utility of that measure.

Conclusions: M-RET applied to pictures resulted in improvements in production of content in treated and untreated picture conditions for the majority of the participants. Treatment effects extended to additional outcome measures. Although some positive changes were observed for the participant with fluent aphasia, maintenance was problematic. Application of M-RET to a personal recount condition was not associated with improved performance for most of the participants.     

The role of bone marrow microRNA (miR) in erythropoietic dysfunction after severe trauma

BackgroundPrevious data has shown that severe traumatic injury is associated with bone marrow dysfunction, which manifests as persistent injury-associated anemia. This study sought to identify whether the expression of erythropoiesis-related microRNAs were altered in the bone marrow of trauma patients to determine if these microRNAs play a role in persistent injury-associated anemia.MethodsBone marrow was collected from severely injured trauma patients who underwent fracture fixation as well as patients who underwent elective hip replacement. There were 27 trauma patients and 10 controls analyzed. Total RNA and microRNA were isolated from CD34-positive cells using the RNeasy Plus Mini kit, and genome-wide microRNA expression patterns were assayed. Genes with significant expression differences were found using BRB-ArrayTools with a significance of P < .01.ResultsThere were marked differences in expression of 108 microRNAs in the trauma group when compared with hip replacement patients. Four of these microRNAs play a role in regulating erythropoiesis: microRNA-150, microRNA-223, microRNA15a, and microRNA-24. These microRNAs were all upregulated significantly, with trauma/hip replacement fold changes of 1.7, 1.8, 1.2, and 1.2 respectively, and all act to suppress or regulate erythropoiesis.ConclusionAssessment of the bone marrow microRNA profile in trauma patients compared to those undergoing elective hip replacement revealed the differential expression of microRNA-150, microRNA-223, microRNA-15a, and microRNA-24. These microRNAs all play a role in decreased erythroid progenitor cell growth and provide important insight to the erythropoietic dysfunction seen after trauma.